Customer form

Individual Insurance Form and Download

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LIST FORM

To facilitate and accelerate the process of the administration of the services we provide, then attached are the types of forms that can be obtained as follows:

  1. Request Form To Change Policy
  2. Policy Change Form For Recovery
  3. Completed forms / Recovery Policy
  4. Money Transfer form
  5. Additional Insurance Request Form "Payor Benefit"
  6. Additional Insurance Request Form "Living Protection"
  7. Additional Insurance Request Form "Hospital Benefit"
  8. Request for Change Form Policyholders
  9. For Change of Address Request Form
  10. Form Loan Policy
  11. Cancellation Policy Form
  12. Cash Payment Letter
  13. Most Investment Fund Withdrawal Form (Partial Surrender) PRO-INVEST
  14. Change Request Form Allocation Fund Investment (ADI) and / or changes Allocation of Premi

 

The above forms can be obtained by:
Customer Contact Center
62 21 2555 7777

Manulife Indonesia
Sampoerna Strategic Square,
South Tower, Lantai 3 – 17
Jalan Jenderal Sudirman Kav.45
Jakarta 12930

Or contact marketing division of Manulife Indonesia


DOWNLOAD FORM

  1. Attorney Debiting Account - Credit Card Form
  2. Attorney Debiting Account - Bank Mandiri Form
  3. Attorney Debiting Account - Bank CIMB Niaga Form
  4. Attorney Debiting Account - Bank BRI Form
  5. Attorney Debiting Account - Bank BCA Form
  6. Attorney Debiting Account - Bank Mandiri Syariah Form
  7. Attorney Debiting Account - Bank CIMB Niaga Syariah Form
  8. Attorney Debiting Account - Bank BRI Syariah Form
  9. Attorney Debiting Account - Bank BCA Syariah Form
  10. Revocation of Power of Attorney Account - Bank BCA Form
  11. Revocation of Power of Attorney Account - Bank BCA Syariah Form
  12. Request for Change of Address Form I (PDF File)
  13. Assured Benefit Payment Agreement Form (PDF file)
  14. Death Claim Form - Individual Insurance (PDF file)
  15. Insured Benefit Claim Form - Individual (PDF file)
  16. Exemption Claim Form Premiums Due to Inability Total - Individual Insurance Page 1 & 2 (PDF file)
  17. Change of Address Form for Policy Sharia - Individual Insurance (PDF file)
  18. Total inability Claim Form (TPD / TTD) DMTM
  19. Beneficiary Claim Form (PDF File)
  20. Outpatient/Maternity Benefit - Individual Insurance Claim Form (PDF file)
  21. Formulir Sertifikasi Diri Badan (FATCA dan CRS)
  22. Formulir Sertifikasi Diri Individu atau Pihak Pengendali (FATCA dan CRS)

 

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